Mechanisms of neuronal cell death and treatments after spinal cord ischemia

对于脊髓缺血后脊髓损伤的评估，由于传统观点认为白质比灰质更不容易受到缺血性损伤，因此灰质损伤主要被作为治疗的靶点。然而，最近的证据表明脊髓缺血后白质损伤和灰质损伤的重要性。我们定量评估了大鼠脊髓缺血后灰质和白质损伤。采用主动脉球囊导管和低血压诱导脊髓缺血（SCI）。再灌注24小时后，采用Basso， Beattie, Bresnahan（BBB）评分法评价后肢运动功能。根据空泡化程度和淀粉样前体蛋白（APP）免疫反应性评估白质损伤程度。结果表明，大鼠脊髓缺血后脑灰质和脑白质均有损伤，且脑白质损伤程度与脑灰质损伤程度及后肢运动功能有良好的相关性。尽管低剂量利多卡因对大鼠脊髓缺血后灰质和白质损伤程度没有影响，但鞘内给予δ阿片受体激动剂SNC80可减轻大鼠脊髓缺血后灰质和白质损伤。

For the assessments of spinal cord injury following the spinal cord ischemia, gray matter injury has been mainly focused as a target for therapy, because of traditional view that white matter is less vulnerable to ischemic injury compared with the gray matter. However, recent evidence suggested an importance of white matter injury as well as gray matter injury following spinal cord ischemia. We quantitatively assessed the gray and white matter injury following spinal cord ischemia in rats. Spinal cord ischemia(SCI) was induced with intra-aortic balloon catheter and hypotension. Twenty-four hours after reperfusion, hind limb motor function was assessed using Basso, Beattie, Bresnahan(BBB) scale scoring. The white matter damage was assessed on the basis of the extent of vacuolation and amyloid precursor protein(APP) immunoreactivity. The results indicated that both gray and white matters were injured following spinal cord ischemia in rats and the degree of white mater injury was well correlated with the severity of gray matter injury and hind-limb motor function. Although low-dose lidocaine did not affect the degree of gray and white matter injury, intra-thecal administration of delta opioid agonist SNC80 attenuated both gray and white matter injury following spinal cord ischemia in rats.